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Hip and Knee Replacement FAQs

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Diagnosis & Treatment Planning FAQs

What is arthritis and why does my knee or hip hurt?

The hip joint and knee joint both have a layer of smooth cartilage that serves as a cushion between bones and allows for smooth motion. Arthritis is a wearing away of the smooth cartilage, eventually down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.

What is a total hip replacement?

A total hip replacement is an operation that removes the arthritic ball of the upper thighbone (femur) as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic or metal liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt.

What is a total knee replacement? A total knee replacement is really a cartilage replacement with an artificial surface.

The knee itself is not replaced, as is commonly thought, but rather an artificial substitute for the cartilage is inserted on the end of the bones. This is done with a metal alloy on the femur and plastic spacer on the tibia and kneecap. This creates a new, smooth cushion and a functioning joint that does not hurt.

What are the typical results of total hip replacement or total knee replacement surgery?

Ninety to ninety-five percent of patients achieve good to excellent results with relief of discomfort and significantly increased activity and mobility.

When should I have a knee replacement or hip replacement?

Your orthopedic surgeon will decide if you are a candidate for the surgery. This will be based on your history, exam, X-rays and response to conservative treatment. The decision will then be yours.

Am I too old for a knee or hip replacement?

Age is not a factor if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for his/her opinion about your general health and readiness for surgery.

What are the major risks?

Most knee and hip replacement patients experience zero complications, however we do use antibiotics and blood thinners to avoid the two most serious complications: infection and blood clots. We also take special precautions in the operating room to reduce the risk of infections.

How long will my new "joint" last?

All implants have a limited life expectancy, which varies depending on an individual's age, weight, activity level and medical condition(s). It is important to remember that an implant is a medical device subject to wear that may lead to mechanical failure. While it is important to follow all of your surgeon's recommendations after surgery, there is no guarantee that your particular implant will last for any specific length of time.

Why might I require a revision?

Just as your original joint wears out, a hip or knee replacement will wear over time as well. The most common reason for revision is loosening of the artificial surface from the bone. Wearing of the plastic spacer may also result in the need for a new spacer. Your surgeon will explain the possible complications associated with total hip or knee replacement.

Will I need a second opinion prior to the surgery?

Your orthopedic surgeon's office will contact your insurance company to pre-authorize your knee or hip replacement surgery. If a second opinion is required, you will be notified.

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Preparing for Surgery FAQs

How do I make arrangements for surgery?

After your orthopedic surgeon has scheduled your surgery, a joint care coordinator will contact you about four weeks before surgery. He or she will guide you through the program and make arrangements for both pre-op and post-op care. The joint care coordinator can be reached at 443-481-1698.

Should I exercise before the surgery?

Yes, consult your orthopedic surgeon and physical therapist about the exercises appropriate for you.

How do I donate my own blood?

Most patients will not need to donate blood. If, however, your physician requests you to donate your own blood, the surgeon's office will help you arrange this.

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Surgery FAQs

How long does the surgery take?

We reserve approximately 2-2 1/2 hours for hip or knee replacement surgery. Some of this time is taken by the operating room staff to prepare for the surgery.

Who will be performing the surgery?

Your orthopedic surgeon will perform the surgery. An assistant often helps during the surgery and that assistant will bill you separately.

Do I need to be put to sleep for my surgery? You may have a general anesthetic, which most people call "being put to sleep."

Some patients prefer to have a spinal or epidural anesthetic, which numbs your legs only and does not require you to be asleep. The choice is between you, your orthopedic surgeon and the anesthesiologist. Your patient guidebook will also detail your options for you.

How long will I be incapacitated?

You will probably stay in bed the day of your surgery. However, the next morning you will get up, sit in a chair or recliner and should be walking with a walker or crutches later that day.

Is knee or hip replacement surgery painful?

You will have discomfort following the surgery, but we will try to keep you comfortable with appropriate medication. Many patients are able to stop very strong medication within one day, and most patients are able to control their own medicine with a special pump that delivers the drug directly into their IV.

How long, and where, will my scar be?

For hip replacement patients, the scar will be approximately six inches long along the side of your hip. For knee replacement patients, the scar will be approximately six inches long, straight down the center of your knee (unless you have previous scars, in which case we may use the existing scar) There may be some lasting numbness around the scar.

How long will I be in the hospital?

Most hip and knee replacement patients will be hospitalized for two nights after their surgery. There are several goals that you must achieve before you can be discharged.

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Recovery FAQs

Where will I go after discharge from the hospital?

Most hip and knee replacement patients are able to go home directly after discharge. Some may transfer to a sub-acute facility and stay there for 3-5 days. Your joint care coordinator and discharge planner will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have sub-acute benefits.

What If I live alone?

Three options are usually available to you:

Will I need a walker, crutches or cane?

Yes, for two weeks you will use a walker or crutches. You will then progress to a cane. You should not switch to a cane until you have practiced with your physical therapist. Switching to the cane too early can result in a limp because your operated knee or hip is not strong enough to support you.

Will I need help at home?

Yes, the first several days or weeks, depending on your progress, you will need someone to assist you with meal preparation and general daily tasks. Family members or friends need to be available to help. Preparing ahead of time, before your hip or knee replacement surgery, can minimize the amount of help required. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed and single portion frozen meals will reduce the need for extra help.

Will I need physical therapy when I go home?

Yes, you will have physical therapy. Patients are encouraged to utilize outpatient physical therapy. If you need home physical therapy, we will arrange for a physical therapist to provide therapy at your home 3 times a week. Following this, you will go to an outpatient facility 3 times a week to further assist in your rehabilitation. The length of time required for this type of therapy varies with each patient.

How long until I can drive and get back to normal?

The ability to drive depends on whether surgery was on your right knee/hip or your left knee/hip and the type of car you have. If the surgery was on your left side and you have an automatic transmission, you could be driving at two weeks. If the surgery was on your right side, your driving could be restricted for as long as six weeks. Getting "back to normal" will depend somewhat on your progress. Consult with your orthopedic surgeon or physical therapist for their advice on your activity. You must be off all narcotic pain medication before driving.

When will I be able to get back to work?

We recommend that most knee and hip replacement patients take at least one month off from work, unless their jobs are quite sedentary and they can return to work with crutches. An physical therapist can make recommendations for joint protection and energy conservation on the job.

When can I have sexual intercourse?

The time to resume sexual intercourse should be discussed with your orthopedic surgeon. The Joint Center has a guide on sexual intercourse and will give you a copy.

How often will I need to be seen by my doctor following the surgery?

Two to three weeks after discharge, you will be seen for your first post-operative office visit. The frequency of follow-up visits will depend on your progress. Many hip and knee replacement patients are seen at six weeks, twelve weeks and then yearly.

Do you recommend any restrictions following surgery?

Yes, high-impact activities, such as running, singles tennis and basketball are not recommended. Injury-prone sports, such as downhill skiing, are also dangerous for the new joint. Hip replacement patients may be restricted from crossing their legs, twisting the operated leg, bending 90 degrees at the hip or twisting side-to-side. Your therapist will help you understand these restrictions in the hospital.

What physical/recreational activities may I participate in after my surgery?

You are encouraged to participate in low-impact activities such as walking and swimming (once your wound is completely healed). If you experience pain, stop and consult your physician before continuing.

Will I notice anything different about my knee or hip?

Will I need any other equipment?

Patients undergoing hip replacement surgery will need a high toilet seat for about three months. We can arrange to have one delivered to you at the hospital, or you can borrow one from friend or family. You will also be taught to use assistive devices to help you with lower body dressing and bathing. You may also benefit from a bath seat or grab bars in the bathroom, which can be discussed with your occupational therapist.

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